The implementation of a self-care tool for patients that may reduce clinician burden.
Authors: Jenny Wei, Juraj Kavecansky, Yan Li, Dinesh Kotak, Amanda Bell, Gregory Marr, Christine B. Weldon, Julia R. Trosman, Raymond Liu
Journal: Journal of Clinical Oncology (2023)

11017 Background: Addressing the side effects and concerns of patients is paramount during cancer treatment. At this time, this significant workload often involves active management by oncology clinicians which may exacerbate clinician burnout. However, minor side effects and routine concerns may be managed by patients themselves. While there are valuable resources available online including Cancer.net by the American Society of Clinical Oncology (ASCO), patients may benefit from a targeted and personalized approach. Herein, we developed a novel online patient self-assessment and self-care tool within Kaiser Permanente Northern California (KPNC), an integrated healthcare system caring for about 4.5 million patients, that aims to help patients with cancer address routine concerns, enabling them to participate in targeted self-management. Methods: Under the novel 4R Oncology model (Right Info / Right Care / Right Patient / Right Time), the self-care tool was implemented to promote patient self-management and improve team-based care and was further developed into a web-based intervention by KPNC. Patients with specific minor concerns were directed to Cancer.net webpages that described how these concerns could be self-addressed. We assessed pageview (a page loaded within a browser) data from May 2021 to December 2022. Main topics were Managing Side Effects and Concerns Related to Your Cancer Treatment, Nutrition Concerns, Emotional or Practical Concerns, Additional Resources and COVID-19 information. If patients were unable to address their concerns with the self-care tool, they were instructed to contact their care team for follow-up. Results: Within the 20-month study period, there were 4,991 total pageviews of the self-care tool. The most pageviews in one month were 501 in November 2022 and the least were 93 in December 2021. Pageviews increased over time with most months in 2022 reaching over 200 pageviews compared to only half of months in 2021 surpassing 200 pageviews. The most frequent pageviews were diarrhea (124), nutrition (124), sleep (101), use of herbs or supplements (100) and nausea or vomiting (98). While there were many topics available on the website, the most viewed pages involved gastrointestinal concerns. The least viewed included Life Care Planning/Advance Health Care Directive (6) and Chemobrain (8). Conclusions: Examination of pageview data from a self-assessment and self-care tool targeting patients with cancer within an integrated healthcare system reveals substantial interest in self-management. While it is unclear whether patients find the self-care tool’s information useful currently, further research is underway using patient surveys to evaluate its utility. Implementation of helpful information can empower visitors to be aware of their options and engage in self-management of routine conditions, which in turn can optimize their health while decreasing oncology clinician burnout.